Figure 2.

Endoscopic ultrasonography guided transgastric insertion of fully covered 10 mm × 15 mm lumen apposing metal stent allows endoscopic access to the subcapsular hepatic hematoma for drainage and debridement. A: Dilatation of the lumen apposing metal stent (LAMS) was needed for the first debridement; B: Endoscopic image showing the LAMS after dilatation during the first of four debridements; C: Endoscopic image showing the subcapsular hepatic hematoma (SHH) during the second debridement; D: After each debridement, a double pigtail stent was inserted into the lumen of the LAMS allowing a more complete drainage of the SHH; E: Endoscopic image showing debris of the hematoma inside the stomach after the last debridement.